Making the choice: Hospital v home?

[kellykins]

I am currently looking for resources to tell me one way or another. my dd was born at a hospital (in FL) and although the OB I went to initially was great, near the end I got tossed to other OBs in the practice that I didn't love and they were really the opposite of my original OB, very pushy, convinced me of going induction AND INITIALLY SCHEDULED AN INDUCTION ON MY DUE DATE.... only to get induced at 40w2d (I am and was perfectly healthy, no elevated concern on anything) with pitocin and water break, and epidural and dd spending time away in the nursery for breathing care, which on reflection I believe was due to the epi.... all uneccesary, and I do not want all of that to happen again.....
BUT
I am very uneasy about birth at home.
very.
As is DH.
Afraid if complications arise, they will be tragic, and we will feel guilty and horribile for the rest of our lives....

The closest birth center is a good half hour drive from here.

The hospital close to here offers whirlpool tubs for laboring in...
but I am ooked of some reason about using a tub at "someone elses" place--- hospital, hotel, birth center, someone elses home.... I can't explain it, I just am ooked. (shudder)

I am so conflicted on this, and am having a hard time finding reliable info that is not biased regarding hospital birth vs home... I'm looking for a true comparison of pros and cons and cant seem to dig em up...

[Mommal]

If I had a birth center a half hour drive from my house, I would have ABSOLUTELY NO PROBLEM using it. I had a choice of 2 hospitals, one 20 minutes away and the other 50 minutes away. We chose the 50 minute drive, and that was not too far to go for better care.

Have you been to the birth center? Go tour it, get a feel for the midwives or docs who work there, ask questions. If it feels right to you, I'd go for it.

Some info on homebirth:
http://www.nchomebirth.com/art-safety.html
http://www.bmj.com/cgi/content/full/330/7505/1416

[SeekingJoy]

I drove 20 minutes to the hospital, half of it pushing. (2 hr labor with my second). I wouldn't think twice about a 30 min drive to a birth center. Unlike a hospital, you don't have to wait until you are in transition to avoid interventions.

[Sheryl1678]

I agree about the birthing center. 1/2 hour is not a long drive and a birthing center is simply an excellent happy medium if you want to avoid most interventions but are uncomfortable with homebirth.

[paintedbison]

You might go tour the birth center and see what you think. I delivered my second at a birth center 45 minutes from my house. It wasn't bad at all getting there. The tubs were super shiny clean. They looked much cleaner than my own bathtubs, lol!

[alegna]

A birthcenter is no "safer" than a homebirth.

I would not birth in a hospital short of a serious medical reason. It's MORE dangerous for normal birth.

-Angela

[SeekingJoy]

:

You might want to check out either http://pushedbirth.com/ or The Thinking Woman's Guide to a Better Birth. There is also the book format available.

[devon]

If you are closer to the hospital than a birth center would be, I would birth at home. A birth center is going to be no safer at all than a homebirth. In our situation, it would have been a 15 minute drive to the birth center. We live 2 minutes from the hospital. If I had to transfer, that would have been 15 minutes to do so versus 2.

At first before I was pregnant with this one (#3) we had reservations about a hospital birth (due in part to #1 being born there, and #2 being born at home unplanned, very quickly). We did some research (the British Medical Journal has an excellent study) and then went ahead and interviewed with midwives, bringing a lot of questions and 'What if's" with us. They answered all of our questions and more, and brought up some good points.

We're going with a home birth for this birth and I am so excited and comfortable with it now.

[rixafreeze]

I agree--30 minutes is nothing if it's the right thing for you. If you really don't feel good about home birth (and this is after researching it, not just your initial reaction), then I don't think you should do it. And this is coming from someone who UC'd her first! That said, I would perhaps take some time to think about your perceptions about "things going wrong" and why you'd blame yourself if it happened at home but not in a hospital or birth center.

I also agree that if you're birthing out-of-hospital, distance/time to emergency care is an important factor to think about.

About the tub--they get throughly cleaned with disinfectant. If you're using the hospital's or the birth center's, I wouldn't be concerned about it at all.

[MegBoz]

Originally Posted by rixafreeze

That said, I would perhaps take some time to think about your perceptions about "things going wrong" and why you'd blame yourself if it happened at home but not in a hospital or birth center.

This is an interesting point. I think the above is a common perception (guilt if something went wrong at home, because you weren't in a hospital "just in case.") DH is a super pro-NCB guy, but still has that same reservation about home birth. (LOL, he's coming around already though for #2! woo hoo!)

I think it stems from cultural perceptions about birth. If we think the hospital is safest because of the technology 'just in case' then we can't help but think that it is risky, dangerous, and even perhaps unethical to birth at home since we deliberately opt out of having technology on hand 'just in case.'

But on the flip side, the many, many things that "go wrong" in a hospital are seen as "just bad things that happen" and "thank goodness we were in the hospital with all that technology to fix things," while ignoring the fact that it was the technology that CAUSED the problems!! (not saying this is the case with you, OP! Just talking about our American culture in general.)

I like to recall though that about 1/3 of all births in the Netherlands are home births - and their rates of maternal & fetal mortality & morbidity are much lower than ours. Home birth itself is not strange or risky. It's just the ACOG & AMA that made us percieve it as such in the US.

There was also a thread on home birth vs. birth center and many posters pointed out the fact that there really isn't any technology at the birth center that a HB MW can't bring with her to your house. So as far as what's on hand "just in case," the birth center isn't any better.

In any case, if you and or DH aren't comfortable with home birth, then 30 min drive is nothing. My doula drove 50 min to the only birth center in our area for her 2 births. (She's doing home birth for her 3rd though.) I have a hospital less than 10 min away, but I chose the one 20 min away instead.

[D'sMama]

Here's a page that has several links to studies, etc. on the safety of homebirth:
http://www.gentlebirth.org/ronnie/homesafe.html

The BMJ study abstract: http://www.bmj.com/cgi/content/abstract/330/7505/1416

Definitely read Henci Goer's Thinking Woman's Guide... and Pushed or Born in the USA. Watch Business of Being Born.

Try to remember that, unfortunately, birth is not completely safe anywhere - not least the hospital, where you have to contend not only with the normal risks of birth, but also with iatrogenic injuries, doctor's schedules, hospital policies based on litigation fears instead of evidence-based care, MRSA, C.diff and other nasty bugs, etc.

You should only birth where YOU are comfortable birthing, but it definitely sounds like some more research (on ALL the options) would be beneficial to you.

And remember that you can always go to the hospital if you want to or need to, but if you don't like what's happening in the hospital, you can't just go home.

[billikengirl]

Originally Posted by SeekingJoy

:

You might want to check out either www.pushed.com or The Thinking Woman's Guide to a Better Birth. There is also the book format available.

I agree! Those are both informative books. The site related to Jennifer Block's book is www.pushedbirth.com

I also liked Born in the USA by Marsden Wagner.

[*MamaJen*]

Jennifer Block's book is awesome.
I'm not Jennifer Block, by the way, even though I totally pimp her book every chance I get.
Also, watching the Business of Being Born is a great introduction to the policies and politics of birth in America.